伊布利特与普罗帕酮在持续性心房颤动射频消融术中转律的应用效果比较

Efficacy of ibutilide vs.propafenone for cardioversion of persistent atrial fibrillation during radiofrequency ablation

目的:探讨伊布利特与普罗帕酮在持续性心房颤动射频消融术中转律的效果。方法:将62例持续性心房颤动患者随机分为伊布利特组(31例)和普罗帕酮组(31例),均在射频消融术中分别静脉注射伊布利特或普罗帕酮,分析2组的治疗效果,治疗前、治疗后30 min和60 min的心电图指标(AA间期、QTc间期和QRS波时限),治疗4 h后的左心房相关指标(瘢痕区比例、IVRT、E、A、E/A),复律不成功患者的心室率变化及治疗4 h内的不良反应。结果:伊布利特组的转律率高于普罗帕酮组(P<0.05),且转律时间(P<0.05)、手术时间(P<0.01)短于普罗帕酮组;治疗后60 min的心电图指标和治疗后4 h的左心房相关指标优于普罗帕酮组;复律不成功患者的心室率下降程度高于普罗帕酮组(P<0.05);总不良反应发生率低于普罗帕酮组(9.68%vs.32.26%,P<0.05)。结论:伊布利特在持续性心房颤动射频消融术中转律的应用效果较好。

OBJECTIVE To explore the efficacy of ibutilide vs. propafenone for cardioversion of persistent atrial fibrillation during radiofrequeney ablation. METHODS 62 cases with persistent atrial fibrillation were randomly divided into ibutilide group and propafenone group. All patients underwent intravenous injection of ibutilide or propafenone after the radiofrequency ablation. The following indices were analyzed such as curative effects （cardioversion rate and the time indicator）, the ECG indi cators （AA interval, QTc interval and QRS wave duration） before treatment, 30 and 60 min after treatment, left atrium indiea tors （proportion of left atrial scar area, IVRT, E, A and E/A） 4 h after treatment, the ventricular rate changes of patients with unsuccessful cardioversion and adverse reactions within 4 h. RESULTS Compared with the propafenone group, the ibutil- ide group had a higher eardioversion rate, less cardioversion and operative time, the superior ECG indicators 60 rain after treat ment and left atrium indicators 4 h after treatment, less changes of ventricular rate changes in patients with unsuccessful cardio version, and lower adverse reactions. CONCLUSION The efficacy of ibutilide for cardioversion of persistent atrial fibrillation during radiofrequency ablation was better.